Providing on-the-scene trauma life-support methods and procedures is important for protecting traumatized patients with suspected back injuries, particularly automobile accident victims at the accident site prior to admission to emergency facilities of a hospital. Previous methods employed by pre-hospital care providers, typically Emergency Medical Technicians (EMT)/Paramedic personnel, for protecting patients of suspected cervical spine injury, when encountered in a standing position at the scene of an accident, are usually governed by methods developed as part of a well-recognized emergency care program known as the Pre-Hospital Trauma Life Support Program, ("P.H.T.L.S."). In this program, it is the standard procedure to "backboard" patients at prescribed times and conditions while in the standing position. The procedure used in backboarding standing patients is to use triangularly folded bandages to secure the patient at the feet and pelvis area to a stretcher device commonly called a "backboard." Alternatively, the standard procedure used when patients, who have been traumatized from accidents, are encountered, other than standing or otherwise upright when a EMT/Paramedic team arrives, is to provide routine emergency care which typically includes having the patient sit or lie down.
When the patient is encountered by EMT/Paramedic personnel in the standing position, it is inappropriate for pre-hospital care providers to sit or lie the traumatized patient down without first applying a fitted cervical collar and a full length backboard, while the patient is standing. Preferably, the patient must be tied to the backboard according to a prescribed "backboarding procedure" developed by the National Association of Emergency Medical Technicians in cooperation with the Committee on Trauma of the American College of Surgeons. The reason care providers do not permit these patients to lie down is that automobile accident victims frequently suffer broken necks as a result of being subjected to rapid deceleration during a collision, wherein the person's head, being heavy, is rapidly displaced relative to the neck column, causing a fracture of the neck column. Often such neck fractures, while serious in and of themselves, do not initially sever nerve cords of the spinal column of a patient which would result in serious injury and paralysis. However, any subsequent movement of the injured patient can result in the nerve cords being severed by a fractured bone and causing serious injury. Typically, the injury to the spinal column occurs after the accident, when the victim either moves while trying to extricate him or herself from the damaged automobile, or, having gotten out of the automobile, has occasion to move his/her head down, the most dangerous movement being to look downward, thereby causing the fractured bones to cut the spinal column causing serious and permanent damage.
Prior art methods and apparatus currently utilized by emergency/rescue teams are directed to tying an upright accident victim/patient an upright rigid stretcher device, commonly known as a "backboard," while standing in an upright position. The object of such method is to support a victim on a backboard while standing to minimize movement of the victim and an resulting neck movement. Once supported on the backboard, the victim is manually transported into an ambulance before the transport to the hospital for emergency care. Such prior art backboards utilize cloth ties devices, commonly known as folded bandages, for securing the victim to the backboard consisting of folded triangular wraps, wherein one wrap is used to tie the feet, another is to tie the torso, and another as appropriate could be used to tie the upper torso to the backboard. Backboards currently used by emergency rescue teams have no support for the victim's feet.
During close observation of various techniques, I have found that special precautions must be taken to prevent downward movement of the patient relative to the backboard while backboarding victims in the standing position. This has been viewed in the field and classroom setting, while well trained experienced EMT/Paramedics perform this task. Using methods from the P.H.T.L.S. program, I have witnessed downward movements of the patient's torso relative to the backboard ranging from 3/8" to as much as 3" in most cases. Therefore, to perform the task of tying a patient to a backboard correctly and to minimize downward movement, it is imperative to take valuable time to perform the task of tying the bandage wraps securely.
In an article published in the Journal of Emergency Medical Science (JEMS), September, 1987; pages 64,65, & 66, the techniques described are quite different. Although the techniques disclosed are faster, there is still downward movements of the patient. Furthermore, great pressure is transferred from the shoulders to the thoracic and cervical spine areas in the JEMS article which may be harmful and is thus undesirable.
Referring to the teaching of the P.H.T.L.S. program, any movement of the patient's arms, legs, shoulders, and pelvis can result in compromise in the entire spinal column. To counteract this, as taught in said program, the backboard when tied to the patient's body becomes a full body splint intended to eliminate movement of such body members and prevent further injury.
As human skills vary from person to person, it is not feasible to ensure uniform quality of care in securely tying the patient to the backboard with sufficient tightness to prevent downward movement of a patient while backboarding the patient who is in the standing position. Accordingly, these prior art devices and methods often fail in their objectives.
Another prior art device discloses in U.S. Pat. No. 3,158,875, Fletcher, shows an "INVALID STRETCHER" incorporating a fabric body portion and a foot support fabric portion for supporting the invalid's feet, including at least one pocket for incorporating a rigid slat. The foot support is adapted to adjust the position of the foot support for invalids of different height, and includes straps for maintaining the invalid's feet immobile in the foot support portion. While the foot support in Fletcher restrains movement of the patient's feet, particularly lateral movement, it is not adapted to support the full weight of the patient to prevent downward movement of the patient's torso relative to the fabric body portion, and associated movement of head and neck.
Such prior art devices, however, have not proven fully effective for complete immobilization of the patient's neck because the tying devices cannot, by themselves, securely hold the victim in position on a stretcher or back board and the victims frequently slump down when they are being moved from the upright position to a generally horizontal supine position for transport. As previously noted, such movement carries the risk of head movement with associated aggravated neck injury, and paralysis.
It is therefore desirable to provide a new, improved back board apparatus and method which is fast to apply thereby reduces delay in providing critical care, is economical, easy to operate, can be retrofitted to back boards currently in use and provides greater immobilization for protection against aggravated neck injury not possessed in prior art stretcher devices or methods.